Eye Health: Is It a Stye or a Chalazion?

If you develop a lump on your eyelid, you may think it’s a stye. And while it might well be, there’s a good chance it’s actually a chalazion.“A what?” you may ask. Here we briefly discuss chalazia (the plural of chalazion) and styes—and how to treat and prevent them.

Chalazion vs. stye: what's the difference?

A chalazion occurs when a meibomian or other sebaceous (oil) gland in the eyelid becomes blocked and triggers an immune response, which results in the growth of a firm, roundish, and usually painless lump. More common on an upper rather than lower eyelid, chalazia tend to develop over several weeks and may then take a month or more to go away—though medical treatment is often required.

A stye (or external hordeolum), on the other hand, occurs when an oil or sweat gland in the eyelid, usually one associated with an eyelash follicle, becomes infected with Staphylococcus aureus or other bacteria. A small yellowish spot inside the inflamed red pimple indicates where pus has collected. Styes, which occur on the outside of the eyelid, are more painful than chalazia and last about a week or two. They swell gradually and then subside, often after they spontaneously rupture and the pus drains. Similar in ways to a stye (though less common), an internal hordeolum is an infection of the meibomian gland that occurs in the interior of the eyelid and is especially painful.

In addition to redness and swelling, these eye conditions can cause tearing, light sensitivity, a sensation that there is something in your eye, and, depending on the size and location, blurred vision. People with chronic blepharitis (inflammation of the eyelids), seborrheic dermatitis, or acne rosacea are more susceptible to developing these conditions.

How to treat chalazia and styes

In the initial days, it’s often hard to tell a chalazion from a stye, but applying a very warm compress is recommended for both. Do this for 10 to 15 minutes, at least four times a day, using a soft, clean cloth. (Heat a wet compress, as needed, in the microwave or by frequently running it under hot water. There are also microwavable heat packs you can buy.) Besides easing discomfort, this helps unclog the oil glands so that a chalazion can resolve, while it helps a stye come to a head. You can also then lightly massage the eyelid for a few minutes to help a chalazion drain. Never squeeze a chalazion or stye.

If a stye doesn’t improve within a week, or a chalazion within a month—or if the lesion is very large or bothersome or is affecting your vision—see your regular doctor or an ophthalmologist or optometrist. Chalazia can be treated with corticosteroid injections, but once well-established they need to be incised (lanced) or surgically removed. For styes, the doctor may pull out the affected eyelashes to allow for drainage. In rare cases, they may need to be treated with antibiotic ointments or drops (oral antibiotics are prescribed only if the infection spreads).

Better yet, how to prevent them

Make a habit of keeping your hands clean and not touching or rubbing your eyes.

Using a cotton ball or swab, gently scrub your eyelids daily with diluted baby shampoo, especially if you have blepharitis. Or use an over-the-counter lid scrub (some come in pre-moistened pads) formulated to remove oil and debris from eyelids.

Don’t wear old eye makeup (change it every four to six months) or share eye makeup. Always remove eye makeup before going to bed.

Always disinfect contact lenses and wash your hands before putting them in and taking them out.

If you have recurrent styes or chalazia, get medical advice, since they can be an indication of an underlying skin condition or other problem.